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Back from the Abyss: Psychiatry in Stories
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Back from the Abyss: Psychiatry in Stories

Author: Craig Heacock MD

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How do we find a way out of the darkest depths of despair? Psychiatrist Dr. Craig Heacock hosts a deep dive into powerfully moving stories of hope and healing, as well as topical explorations of psychopharmacology, psychotherapy, and psychedelics.

118 Episodes
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Kate lived for many years in a hazy and numbing dialectic, thinking that her life was “perfect”, but also having a vague and gnawing sense that just under the surface something was terribly wrong. This is a story of forgetting and remembering, a story of finding a therapist who was willing and able to sit through years of hateful negative transference and let Kate work through her parent-child wounds. And finally this is a story of MDMA and psilocybin helping someone move forward ...
Very few people are willing and/or able to share and describe their descent into psychosis— in part because memory formation and consolidation are so impaired during episodes of psychosis…..and also because there is often so much fear and shame tied up in the experience of losing one’s mind. Here Dr. H's patient Corben describes his very early onset illness, how it started with years of depression, then shifted into profound alienation and increasingly frightening psychosis, and f...
The prevailing model of psychiatric care in the US is called "med management"-- this typically means a 10-15min appointment to review symptoms and choose medications. Here Dr. Will Van Derveer of the Integrative Psychiatric Institute sits down with Dr. H to deconstruct this deeply flawed model and posit a more holistic and hopeful way of thinking about psychiatric care. Dr. Van Derveer and the Integrative Psychiatric Institutehttps://psychiatryinstitute.com/BFTA/ Dr. Hhttps://www.c...
In this season 6 opener Dr. H sits down with Dr. Erin Jacklin of the Catalyst Center in Denver to explore how we learn to the deeply complex and consistently challenging work of doing good therapy.BFTA on IG @backfromtheabysspodcasthttps://www.instagram.com/backfromtheabysspodcast/BFTA/ Dr. Hhttps://www.craigheacockmd.com/podcast-page/
Craig sits down with Dori Lewis of Elemental Psychedelics to explore the myths and realities of working with psilocybin mushrooms, including: •What do people not understand about psilocybin mushrooms?•Can mushrooms treat depression? If so, which types?•How should we think about the specific roles of mushrooms and ketamine in psychiatric and psychological treatment?•What kinds of problems are most amenable to psilocybin?•Why do some people have no psychedelic experience on apparently therapeut...
Fishbowl 5

Fishbowl 5

2024-05-3101:00:39

Chris and Craig go meta to deconstruct season 5, explore the art of storytelling and music selection, and answer listener questions.BFTA on IG @backfromtheabysspodcasthttps://www.instagram.com/backfromtheabysspodcast/BFTA/ Dr. Hhttps://www.craigheacockmd.com/podcast-page/
Christina grew up with a tumultuous and mentally ill mother, an older brother who decompensated into psychosis and frightening aggression, and just one healthy family member, her father. Dr. H and Christina explore both the wounding of having a desperately ill parent, as well as the profound gift of having another parent able to provide love and support. Christina suffered terribly from these maternal wounds, but she was also able to finally emerge as a healthy, grateful, wise, and dee...
Dr. Russell Carr was a career Navy psychiatrist for 20 years and served in Iraq, where today’s story begins. This is a story of a healer, then a terrible wounding, then the healer trying to find his way amidst the chaos of war. This story is about a rite of passage, one that not every psychiatrist faces, but most do at some point-- that of losing the first patient to suicide, then trying to find the strength to move forward.Dr. Russell CarrA Psychiatrist Returns from War-- on Substackht...
A huge problem with current psychiatric diagnosis is that it often lumps completely unrelated things under the same vast and vague tent, such as with the diagnosis of "Major Depressive Disorder". Here Craig sits down with his patient Rebecca to try to make sense of her complex early onset depression and how it played out via addiction, anorexia, and pathological caretaking and how she was finally able find the grace and compassion to prioritize care for herself.Bringing Therapy into Me...
Here Dr. H sites down with Jenny, a psychoanalyst who shares her moving, then horrifying, then eventually cathartic tale of plumbing the depths of her traumatized psyche, first with years of psychoanalysis, then with five MDMA-assisted therapy sessions. This is a story of numbing and forgetting, then re-opening and remembering...of finding a way to make sense of a life of protective dissociation.Bringing Therapy into Med Management-- An intensive psychotherapy training in Colorado with Dr.&nb...
In this solo episode Craig shares his current thoughts on MDMA medicalization, sleep meds, ADD, motivation vs self-discipline, benzos, how long to stay on psych meds, a change and a proposed addition to his top 10 med list, borderline vs bipolar, and marriage.Bringing Therapy into Med Management-- An intensive training with Dr. Hhttps://www.craigheacockmd.com/training/BFTA on IG @backfromtheabysspodcasthttps://www.instagram.com/backfromtheabysspodcast/BFTA/ Dr. Hhttps://www.craigheacock...
Dr. H sits down with Dr. Jennifer Gaudiani, a nationally recognized expert on eating disorders to explore a wide range of topics including:• etiology and the relative influence of temperament, culture, and concomitant psychiatric illness•anorexia as a qualitatively different kind of treatment challenge•treatment ambivalence, building the alliance, respecting protectors•anosognosia and its relationship with severity of illness•how to talk about weight, body image, and eating with mindful/respe...
The driving force of so many of our self-destructive tendencies is not conscious, it’s an unconscious drive called the repetition compulsion, where we try to reenact early child traumas or deficits, often consciously hoping for a different result but unconsciously walking directly and knowingly into the flames. One of the central tasks of therapy is often helping people identify their repetition compulsions and doing the deeply uncomfortable work of making different choices. For the rep...
Psychiatry in the ER

Psychiatry in the ER

2024-02-0901:00:48

The rising tide of psychiatric emergencies in the US most commonly ends up in the emergency room, where psychiatrists are almost never found and the brunt of the heavy lifting falls on emergency medicine physicians. Here Dr. H sits down with Dr. Treve Henwood, an emergency med physician and host of the Rural EM podcast to explore the often overwhelming challenges inherent in trying to effectively manage and treat these psychiatric crises.BFTA on IG @backfromtheabysspodcasthttps://www.in...
This is an interview Dr. H did a few months ago on the Radically Genuine podcast. Although we posted about this interview on our Instagram feed back in August, we thought this was worth re-releasing on the main BFTA feed. Of all the podcast interviews Dr. H has done, this one might be the most interesting and relevant for our listeners.Here Dr. H discusses the deep structural problems with current psychiatry, the confusion around psychiatric diagnoses and nosology, controversies and mis...
What does it feel like to be manic? It can be very difficult for people to accurately recall manic episodes— they aren’t stored like typical narrative memories, but rather they often feel like confusing and out of control reveries that seem to have happened to a different version of themselves. Then comes the guilt and the shame that often follows manic episodes, as a result of the loss of normal social inhibition, the lack of fear, and the surging dopamine levels… leading people to tak...
Craig sits down with Carrie Haynes, a colleague and Colorado-based group therapist and host of the podcast The Art of Groups. They explore their shared love of group process, the unique benefits and risks of working with groups, specific challenges for the group therapist or leader, and finally how and why Carrie is moving away from traditional group therapy to a more heart-focused transpersonal group model. Carrie Haynes/The Art of Groupshttps://www.artofgroups.com/BFTA on IG @backfromtheaby...
In the streets and sidewalks of every American city, a slow motion disaster is unfolding, with ever increasing numbers of people suffering from serious mental illness and/or addiction. Why is this happening? What can we do to help our most vulnerable citizens? Here Dr. H sits down with Dr. Dave Iverson, a Colorado psychiatrist, advocate, and policy expert who has devoted his entire career to caring for the most ill patients with the least resources. We get to hear what it's like t...
Saj Razvi returns to BFTA to discuss a listener letter, which leads to an exploration of treatment resistance, developmental trauma, the absence of experience ("the void") vs dissociation as experience. Saj and Craig also explore attachment vs love, whether trauma healing has to be difficult, and the common elements of successful trauma treatment.Saj Razvi and the Psychedelic Somatic Institutehttps://www.psychedelicsomatic.org/BFTA/ Dr. Hhttps://www.craigheacockmd.com/podcast-page/
Some of the most basic questions about ketamine are still under investigation— Which patients are ideal responders? What is the therapeutic dose range? Is there a meaningful dose/response curve? Are fully dissociative treatments necessary for optimal efficacy? How important is psychotherapy after a higher dose IV or IM session? And how should we think about frequency of initial treatments and then ongoing maintenance treatments, if needed?Here Dr. H synthesizes and summarizes his experi...
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